The UK’s chief dentist faces calls for an investigation after describing homeless patients as “difficult… no hopers” whose treatment leads practices to miss strict NHS targets.
Mick Armstrong, the chair of the British Dental Association (BDA), made the remarks in an erroneous email reply to Labour MP Stella Creasy, who contacted him over issues in her constituency.
In the email, seen by HuffPost UK, Armstrong describes Creasy as being “wrong” about a legal requirement for dentists to accept patients regardless of their housing status.
He goes on to write of those without a fixed address: “These are difficult patients who rarely complete a course of treatment.”
“If we took in all the no hopers who ring us…I suspect we’d miss our targets by a country mile,” he added.
It appears from the exchange seen by HuffPost that Armstrong copied the Walthamstow MP into his reply by mistake.
Creasy has previously questioned health minister Jackie Doyle-Price on the topic, citing problems among homeless people in her Walthamstow constituency with accessing dental care, and contacted the BDA for more information on its response to the problem.
The MP replied to Armstrong’s email to say: “Thanks for sharing this with me – I’m sorry to hear of you call homeless residents ‘no hopers’”.
Armstrong later told Creasy he stood by the broader argument he was making about the treatment of homeless people, “[i]rrespective of the terminology” he said.
He has since said he “regrets” the “intemperate wording” of his email, which he claimed was borne out of frustration with NHS targets.
Dentists receiving NHS funding are required to demonstrate that they meet targets governing the numbers of patients they treat each year.
There have been concerns from practices about resources available to treat patients with acute dental problems.
The BDA has previously called for appointments to be paid whether a patient attends or not, to improve access to treatment for rough sleepers.
Creasy said she was “shocked” by Armstrong’s comments, and called for the matter to be investigated by the dental regulator.
She told HuffPost: “To say I was shocked to hear any group of patients be described as ‘no hopers’, let alone it be acceptable to restrict their service access as a result, is an understatement – homeless people are some of the most vulnerable residents in our communities and getting them registered so they can have check-ups to prevent poor dental care is vital to protecting their health.
“The BDA themselves flagged up to me research showing 15% of homeless people have pulled their own teeth out for want of treatment – so for the chair of this organisation to instead be more concerned about promoting a wine and canapé reception and justifying turning people away for treatment beggars belief.
“If the minister won’t even speak up to challenge this then I think this matter should be referred to the [General Dental Council] for investigation.”
The homelessness charity Groundswell published research in October last year which found 15% of rough sleepers surveyed said they had pulled out their own teeth.
At the time, the BDA responded: “A civilised society does not leave homeless people handicapped by oral disease or resorting to pulling out their own teeth. There is no easy solution, but any progress is impossible without adequately resourced mainstream and dedicated services.”
A 2012 academic study published in the journal Nature found significant need among homeless people in London for dental work and observed how flexible dental services increased the uptake of treatment.
Armstrong said in a statement: “I regret the intemperate wording I used in my exchange with Stella Creasy. The language was inappropriate but born of the frustration (sic) that all NHS dentists in England feel working under a contract that’s decisively failed both patients and practitioners.
“I work as an NHS dentist near Wakefield, and like many colleagues, I treat homeless patients, but it is not easy under the current contract. The NHS effectively caps the number of patients we can treat and fails to cater for those most in need. Dentists are desperate for a system that will allow them to put their patients first.
“The BDA has long championed vulnerable patients, and has argued to ensure that they have access to services that are really tailored to their needs.
“Sadly any headway seems impossible under the existing contract. We are still waiting for Ministers to honour their pledges, and put an end to a system that puts government tick boxes and targets ahead of patient care.”
The General Dental Council said it doesn’t comment on any complaints or investigations until they proceed to a formal hearing.
The Department of Health has been approached for comment.